Provider Demographics
NPI:1578571881
Name:WEISS, ALLAN S (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:S
Last Name:WEISS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10744
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33757-8744
Mailing Address - Country:US
Mailing Address - Phone:727-532-0002
Mailing Address - Fax:727-266-4943
Practice Address - Street 1:1201 5TH AVENUE NORTH
Practice Address - Street 2:SUITE 202
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-1410
Practice Address - Country:US
Practice Address - Phone:727-820-7701
Practice Address - Fax:727-820-7700
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME645262084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01647293OtherRAILROAD MEDICARE PROVIDER NUMBER FOR BMG
FL059268400Medicaid
FLP00883458OtherMEDICARE RAILROAD PROVIDER NUMBER
FLP01647293OtherRAILROAD MEDICARE PROVIDER NUMBER FOR BMG
FLP00883458OtherMEDICARE RAILROAD PROVIDER NUMBER